Alexander Spencer Edwards, MSW
Individual provider Active NPI Social Worker · Corcoran, CA
NPI 1629109269 · NPPES record last updated May 8, 2023
Key facts
- NPI
- 1629109269
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LCSW28987 (CA)
- Practice address
- 900 Quebec Ave
Corcoran, CA 93212-9715 - Phone
- (805) 796-1894
- Fax
- (818) 800-3643
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230519002460 | CA | Practitioner - Clinical Social Worker | 8123484979 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28987 | CA | MD | Clinical Social Worker |
| LCSW28987 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-State Community Healthcare Center | Current |
Accepting new patients | |
| Sud Specialty Group - Ca | Clinical | Current |
Accepting new patients |
Locations
11888 Bartlett Ave
Adelanto, CA 92301
Phone (760) 530-9944
11499 Bartlett Ave
Adelanto, CA 92301
Phone (760) 444-4258
820 W Broadway St
Needles, CA 92363
Phone (730) 326-0222
4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428
5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182
520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW28987 | CA | |
| Social Worker | 104100000X | LCSW28987 | CA | Yes |
Addresses
Primary practice location
900 Quebec Ave
Corcoran, CA 93212-9715
Mailing address
PO Box 691
Corcoran, CA 93212-0691
Phone (805) 796-1894
Other providers in Corcoran, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.